Mia Marie Gardner

Individual provider Active NPI Case Manager/Care Coordinator · Viroqua, WI

NPI 1952583437 · NPPES record last updated Nov 27, 2007

Key facts

NPI
1952583437
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
1321 N Main St
Viroqua, WI 54665-1156
Phone
(608) 637-7052
Fax
(608) 637-8500
NPI assigned
Nov 27, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Family & Children'S Center, Inc. Past Accepting new patients
Family Service of Winona Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

1321 N Main St
Viroqua, WI 54665-1156

Mailing address

66 E 3Rd St
201
Winona, MN 55987-3478
Phone (507) 452-7292

Other providers in Viroqua, WI

All providers in Viroqua, WI · Case Manager/Care Coordinator in Wisconsin

Sources for this page

Verify at the official NPI Registry.